Department of Biomedical Engineering Jimma University, Jimma Institute of Technology
Department of Biomedical Engineering Jimma University, Jimma Institute of Technology
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riming
The deairing of CPB circuit is done by priming solutions, consisting of a mixture of crystalloids and colloids.
Priming causes haemo dilution which improves flows during hypothermia. Heparin 3–4 units/ml is added to
the prime. Depending on the pre-bypass haemoglobin and priming volume, addition of external blood may be
required to maintain a target haematocrit on bypass (21%–24% in adults and 28%–30% in children). The
following equations are used.
Total circulating volume (TCV) = Patient's blood volume + priming volume
Target haematocrit (Hct) on CPB = Patient's blood volume (PBV) × Hct/TCV
Blood required on prime = (Target Hct × TCV) – (Pt. Hct × PBV)/Hct of donor blood
Cardiac index of a 70 kg adult with normal metabolism at 37°C is 2.2–2.4 L/m 2/min. For each 1°C decrease in
temperature, the required cardiac output reduces by 7%, and the pump flow can be reduced by an equivalent
factor. Knowing the body surface area (BSA) of the patient, the required pump flow is as follows:
Pump flow rate = BSA × Cardiac index
In general, turbulence occurs when disrupting forces (inertial) overcome the retaining forces (viscous). This
relationship is expressed by the Reynolds number [= (density x velocity x diameter) ÷ viscosity].
Empirically, turbulence has been found to occur in blood when this number exceeds 1,000, although
curvature, smoothness, and inlet conditions also influence its occurrence.